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Gunay T, Oztas SC. Left Atrial Mechanical Function And Stiffness In Patients With Premature Ventricular Contraction: A Speckle Tracking Study. KARDIOLOGIIA 2023; 63:84-90. [PMID: 37970860 DOI: 10.18087/cardio.2023.10.n2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/08/2023] [Indexed: 11/19/2023]
Abstract
AIM Ventricular extrasystole (PVC) is characterized by premature ventricular depolarization and is associated with increased risk of arrhythmias and structural heart disease. This study aimed to investigate the association between the PVC burden and left atrial (LA) function in individuals without known cardiac disease. MATERIAL AND METHODS A cross-sectional study was conducted on 102 patients with PVCs who were admitted to a cardiology clinic. Transthoracic echocardiography was used to assess left ventricle (LV) parameters, including LV mass, LV ejection fraction (LVEF), LV global longitudinal strain (LVGLS), and LA function was evaluated using strain imaging. The PVC burden was categorized into three groups: <10 %, 10-20 %, and >20 %. RESULTS Changes in LV dimensions and LV mass index were associated with the groups with the PVC burden with 10-20 %, and >20 %. but differences in LVEF and LVGSL were not significant. Mean E / e' increased as the PVC burden increased (p<0.001). The mean global LA peak strain decreased as the PVC burden increased (p<0.001), while other mean LA measurements increased as the PVC burden increased (p<0.001) A higher PVC burden was associated with impaired LA function, as indicated by decreased global LA peak strain (PVC burden <10 %=38.1±3.2 vs. PVC burden 10-20 %=32.4±3.2 vs. PVC burden >20 %=27.7±2.6, in all groups p<0.001) and with increased LA stiffness (PVC burden <10 %=18.6±3.2 vs. PVC burden 10-20 %=27.5±5.5 vs. PVC burden >20 %=39.0±7.9, in all groups p<0.001). A strong negative correlation was found between global LA peak strain and LA stiffness (r=-0.779, p<0.001). CONCLUSION In individuals without known cardiac disease, a higher PVC burden was associated with impaired LA function, indicated by increased E / e', decreased LA strain, and increased LA stiffness. These findings suggest that PVC burden may contribute to LA dysfunction, potentially increasing the risk of cardiovascular events.
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Affiliation(s)
- T Gunay
- Health Sciences University, Bursa City Hospital
| | - S C Oztas
- Health Sciences University, Bursa City Hospital
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Sun Y, Yu X, Xiao X, Dai S, Zhang R, Wang Z, Ma C, Yin X, Gao L, Yang Y, Xia Y. Cardiomyopathy induced by premature ventricular contractions with ventricular escape beats in the compensatory pause: A case report and brief review of the literature. Medicine (Baltimore) 2022; 101:e30277. [PMID: 36042677 PMCID: PMC9410576 DOI: 10.1097/md.0000000000030277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE We reported a case with cardiomyopathy induced by frequent premature ventricular contractions (PVCs) and followed ventricular escape beats (VEBs). PVCs with VEBs in the compensatory pause which induced cardiomyopathy is rarely reported. Also, the case exhibited many characteristics of PVCs which were more likely to induce cardiomyopathy, like the location of origin, the longer coupling interval, and the QRS wave companied with the P wave. PATIENT CONCERNS A 53-year-old man with left ventricular (LV) dysfunction presented with palpation, chest distress, and dyspnea for 3 years. Holter revealed a high burden of ventricular rhythm of PVCs and another wide QRS patterns (96,562 total beats with 87,330 wide QRS beats in 24 hours). The LV ejection fraction decreased to 34% and the left ventricle, right and left atria all dilated. DIAGNOSIS He was diagnosed with PVC-induced cardiomyopathy. INTERVENTIONS The patient experienced intracardiac electrophysiological examination which revealed frequent PVCs followed by VEBs in the compensatory pause. Activation mapping of the PVCS and ablation were performed. OUTCOMES PVCs and VEBs disappeared after ablation. The LV ejection fraction increased to 46% at 2 days after the procedure. The diameters of the right and left atria were also significantly reduced. LESSONS VEBs may occur during the compensatory pause of PVCs. PVCs with VEBs can lead to a high burden of ventricular rhythm and LV dysfunction. Ablation of the PVCs can also eliminate VEBs and improve the LV function.
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Affiliation(s)
- Yuanjun Sun
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaohong Yu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xianjie Xiao
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Shiyu Dai
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Rongfeng Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Zhongzhen Wang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Chengming Ma
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaomeng Yin
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- *Correspondence: Xiaomeng Yin, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Rd, Dalian, Liaoning 116011, China (e-mail: ; )
| | - Lianjun Gao
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yanzong Yang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yunlong Xia
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Fadel BM, Pibarot P, Kazzi BE, Al-Admawi M, Galzerano D, Alhumaid M, Alamro B, Mahjoub H, Echahidi N, Mohty D. Spectral Doppler Interrogation of the Pulmonary Veins for the Diagnosis of Cardiac Disorders: A Comprehensive Review. J Am Soc Echocardiogr 2021; 34:223-236. [DOI: 10.1016/j.echo.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
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Hayashida A, Toki M, Kawamoto T, Hirohata A, Yoshida K. Heart Failure with Masked Atrial Contraction Detected on Echocardiography. J Cardiovasc Imaging 2019; 28:152-155. [PMID: 31805620 PMCID: PMC7114452 DOI: 10.4250/jcvi.2019.0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Akihiro Hayashida
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan.
| | - Misako Toki
- Clinical Laboratory, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Takahiro Kawamoto
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Atsushi Hirohata
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kiyoshi Yoshida
- Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
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Wu WC, Ma H, Xie RA, Gao LJ, Tang Y, Wang H. Evaluation of Left Ventricular Diastolic Dysfunction with Early Systolic Dysfunction Using Two-Dimensional Speckle Tracking Echocardiography in Canine Heart Failure Model. Echocardiography 2015; 33:618-27. [PMID: 26661342 DOI: 10.1111/echo.13133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND This study evaluated the role of two-dimensional speckle tracking echocardiography (2DSTE) for predicting left ventricular (LV) diastolic dysfunction in pacing-induced canine heart failure. METHODS Pacing systems were implanted in 8 adult mongrel dogs, and continuous rapid right ventricular pacing (RVP, 240 beats/min) was maintained for 2 weeks. The obtained measurements from 2DSTE included global strain rate during early diastole (SRe) and during late diastole (SRa) in the longitudinal (L-SRe, L-SRa), circumferential (C-SRe, C-SRa), and radial directions (R-SRe, R-SRa). Changes in heart morphology were observed by light microscopy and transmission electron microscopy at 2 weeks. RESULTS The onset of LV diastolic dysfunction with early systolic dysfunction occurred 3 days after RVP initiation. Most of the strain rate imaging indices were altered at 1 or 3 days after RVP onset and continued to worsen until heart failure developed. Light and transmission electron microscopy showed myocardial vacuolar degeneration and mitochondrial swelling in the left ventricular at 2 weeks after RVP onset. Pearson's correlation analysis revealed that parameters of conventional echocardiography and 2DSTE showed moderate correlation with LV pressure parameters, including E/Esep' (r = 0.58, P < 0.01), L-SRe (r = -0.58, P < 0.01), E/L-SRe (r = 0.65, P < 0.01), and R-SRe (r = 0.53, P < 0.01). ROC curves analysis showed that these indices of conventional echocardiography and strain rate imaging could effectively predict LV diastolic dysfunction (area under the curve: E/Esep' 0.78; L-SRe 0.84; E/L-SRe 0.80; R-SRe 0.80). CONCLUSION 2DSTE was a sensitive and accurate technique that could be used for predicting LV diastolic dysfunction in canine heart failure model.
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Affiliation(s)
- Wei-Chun Wu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong Ma
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Echocardiography, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Rong-Ai Xie
- Department of Cardiology, Peking University Shougang Hospital, Beijing, China
| | - Li-Jian Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Tang
- The Animal Experimental Center of Fuwai Hospital, Beijing, China
| | - Hao Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Kuroki K, Tada H, Seo Y, Ishizu T, Igawa M, Yamasaki H, Igarashi M, Machino T, Naruse Y, Sekiguchi Y, Murakoshi N, Aonuma K. Prediction and mechanism of frequent ventricular premature contractions related to haemodynamic deterioration. Eur J Heart Fail 2014; 14:1112-20. [DOI: 10.1093/eurjhf/hfs095] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Kenji Kuroki
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Hiroshi Tada
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Yoshihiro Seo
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Tomoko Ishizu
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Masayuki Igawa
- Cardiovascular Division; Tsukuba Memorial Hospital; Tsukuba Ibaraki Japan
| | - Hiro Yamasaki
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Miyako Igarashi
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Takeshi Machino
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Yoshihisa Naruse
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Yukio Sekiguchi
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Nobuyuki Murakoshi
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
| | - Kazutaka Aonuma
- Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences; University of Tsukuba; 1-1-1 Tennodai, Tsukuba 305-8575 Ibaraki Japan
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Monitoring of heart failure: comparison of left atrial pressure with intrathoracic impedance and natriuretic peptide measurements in an experimental model of ovine heart failure. Clin Sci (Lond) 2011; 120:207-17. [PMID: 20846122 PMCID: PMC2990201 DOI: 10.1042/cs20100388] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Monitoring of HF (heart failure) with intracardiac pressure, intrathoracic impedance and/or natriuretic peptide levels has been advocated. We aimed to investigate possible differences in the response patterns of each of these monitoring modalities during HF decompensation that may have an impact on the potential for early therapeutic intervention. Six sheep were implanted with a LAP (left atrial pressure) sensor and a CRT-D (cardiac resynchronization therapy defibrillator) capable of monitoring impedance along six lead configuration vectors. An estimate of ALAP (LAP from admittance) was determined by linear regression. HF was induced by rapid ventricular pacing at 180 and 220 bpm (beats/min) for a week each, followed by a third week with daily pacing suspensions for increasing durations (1–5 h). Incremental pacing induced progressively severe HF reflected in increases in LAP (5.9 ± 0.4 to 24.5 ± 1.6 mmHg) and plasma atrial (20 ± 3 to 197 ± 36 pmol/l) and B-type natriuretic peptide (3.7 ± 0.7 to 32.7 ± 5.4 pmol/l) (all P<0.001) levels. All impedance vectors decreased in proportion to HF severity (all P<0.001), with the LVring (left ventricular)-case vector correlating best with LAP (r2=0.63, P<0.001). Natriuretic peptides closely paralleled rapid acute changes in LAP during alterations in pacing (P<0.001), whereas impedance changes were delayed relative to LAP. ALAP exhibited good agreement with LAP. In summary, impedance measured with an LV lead correlates significantly with changes in LAP, but exhibits a delayed response to acute alterations. Natriuretic peptides respond rapidly to acute LAP changes. Direct LAP, impedance and natriuretic peptide measurements all show promise as early indicators of worsening HF. ALAP provides an estimate of LAP that may be clinically useful.
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LAURENT GABRIEL, LEONG-POI HOWARD, MANGAT IQWAL, KORLEY VICTORIA, PINTER ARNOLD, HU XUDONG, SO PETSYPUISZE, RAMADEEN ANDREW, DORIAN PAUL. Influence of Ventriculoatrial Timing on Hemodynamics and Symptoms During Supraventricular Tachycardia. J Cardiovasc Electrophysiol 2009; 20:176-81. [DOI: 10.1111/j.1540-8167.2008.01276.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Hori Y, Ukai Y, Uechi M, Hoshi F, Higuchi SI. Relationships between velocities of pulmonary venous flow and plasma concentrations of atrial natriuretic peptide in healthy dogs. Am J Vet Res 2008; 69:465-70. [PMID: 18380577 DOI: 10.2460/ajvr.69.4.465] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the relationship between velocities of pulmonary venous flow (PVF) and plasma concentrations of atrial natriuretic peptide (ANP) in healthy dogs. ANIMALS 7 healthy Beagles. PROCEDURES Dogs were anesthetized, intubated, and positioned in left lateral recumbency. Lactated Ringer's solution was infused (200 mL/kg/h) for 60 minutes via a cephalic vein. Transmitral flow and PVF velocities were measured echocardiographically by use of the apical 4-chamber view. Pulmonary capillary wedge pressure (PCWP) and ANP concentrations were determined. RESULTS IV infusion significantly increased heart rate and PCWP. Similarly, the ANP concentration significantly increased from baseline (before infusion of lactated Ringer's solution) values. Transmitral flow velocities were significantly increased, although the ratio of velocity of the flow during early ventricular diastole (E wave) to velocity of the atrial flow (A wave; E:A ratio) was unchanged. Regarding the PVF velocities, forward flow during ventricular systole (S wave) and retrograde flow during atrial contraction were significantly increased, whereas velocity of the forward flow during ventricular diastole (D wave) was unchanged. Ratio of the velocity of the S wave to velocity of the D wave was increased significantly, and this ratio was significantly correlated with PCWP or ANP concentration. However, the E:A ratio was not correlated with PCWP or ANP concentration. CONCLUSIONS AND CLINICAL RELEVANCE PVF velocities were strongly correlated with PCWP and plasma ANP concentration in clinically normal dogs. Therefore, PVF velocities may serve as a sensitive indicator and provide additional information for monitoring acute preloading conditions and estimating atrial filling abnormalities in dogs.
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Affiliation(s)
- Yasutomo Hori
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, 23-35-1 Higashi, Towada, Aomori 034-8628, Japan
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Simultaneous right atrioventricular pacing: a novel model to study atrial remodeling and fibrillation in the setting of heart failure. J Card Fail 2008; 14:254-62. [PMID: 18381190 DOI: 10.1016/j.cardfail.2007.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Revised: 10/21/2007] [Accepted: 10/25/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is a common arrhythmia which contributes to morbidity and mortality in patients with heart failure (HF). Atrial remodeling is a key substrate for the development of AF in HF. However, experimental models that study AF in the setting of HF have important limitations. We evaluated a new dog model of atrial remodeling and AF. METHODS AND RESULTS Twenty-two mongrel dogs were randomized into 2 groups: 14 dogs with simultaneous atrioventricular pacing (SAVP) for 2 weeks (220 beats/min, no AV delay) and 8 control dogs with no pacing. SAVP for 2 weeks induced marked changes in atrial mechanical function and conduction. Left atrial area fractional shortening decreased 61 +/- 17%, whereas left ventricular area fractional shortening decreased by 38 +/- 18% from baseline (both P < .05). Conduction slowed and conduction heterogeneity increased. AF was induced in 83% of SAVP dogs, lasting a median of 1600 seconds, versus no dogs with induced AF in the controls. SAVP significantly increased nonfibrillar collagen in the mid-myocardium of both atrial appendages and matrix metalloproteinase-9 activity. CONCLUSIONS SAVP in dogs induces structural and electrical remodelling that form the substrate for reproducibly inducible AF. This novel model may be useful for studies of the pathophysiology and treatment of AF in heart failure.
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Hori Y, Kanai K, Nakao R, Hoshi F, Higuchi SI. Assessing diastolic function with Doppler echocardiography using a novel index: ratio of the transmitral early diastolic velocity to pulmonary diastolic velocity. J Vet Med Sci 2008; 70:359-66. [PMID: 18460830 DOI: 10.1292/jvms.70.359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We developed a novel index to assess left ventricular (LV) relaxation as the ratio of transmitral early diastolic velocity to pulmonary diastolic velocity (E/D ratio). Mixed breed dogs (n=7) were anesthetized and their respiration was controlled. A 3.5-Fr micromanometer-tipped catheter was placed into the left ventricle. Dobutamine (5.0 or 10 microg/kg/min) or esmolol (100 or 500 microg/kg/min) was administered via the cephalic vein. The transmitral flow (TMF) and pulmonary venous flow (PVF) were recorded using transthoracic echocardiography from the apical long-axis view. The heart rate, systolic LV pressure, +dP/dt, and -dP/dt were significantly elevated by dobutamine, but significantly reduced by esmolol. Dobutamine significantly decreased tau, whereas esmolol significantly increased tau. The TMF-derived E and PVF-derived D wave velocities increased significantly with dobutamine, but decreased significantly with esmolol. A significant correlation was detected between the E and D wave velocities (r=0.92). Consequently, the E/D ratio was decreased significantly with dobutamine, and increased significantly with esmolol. Furthermore, the E/D ratio was significantly correlated with -dP/dt (r= -0.64) and tau (r=0.84). Our results suggest that the E/D ratio reflects LV relaxation, and may potentially provide further information on LV relaxation.
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Affiliation(s)
- Yasutomo Hori
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, Towada, Aomori, Japan
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Laurent G, Moe G, Hu X, Leong-Poi H, Connelly KA, So PPS, Ramadeen A, Doumanovskaia L, Konig A, Trogadis J, Courtman D, Strauss B, Dorian P. Experimental studies of atrial fibrillation: a comparison of two pacing models. Am J Physiol Heart Circ Physiol 2008; 294:H1206-15. [PMID: 18178723 DOI: 10.1152/ajpheart.00999.2007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Rapid ventricular pacing (RVP) is a well-established animal model of atrial fibrillation (AF). However, this model is limited by a high mortality rate and severe heart failure. The purpose of our study was to assess a new canine model of inducible AF. We performed acute, short-term, simultaneous atrioventricular pacing (SAVP) and RVP (in random order) in 14 dogs for 30 s. SAVP produced more echocardiographic pulmonary venous flow reversal, a greater increase in mean pulmonary capillary wedge pressure, and a significantly greater decrease in left atrial emptying function (-84.4 +/- 38.6% vs. -23.7 +/- 27.1%, P < 0.05) than RVP. Thirty dogs were randomized to three, longer-term, study groups: eight dogs in the control group (no pacing), eight dogs in the RVP group (2 wk at 240 beats/min followed by 3 wk at 220 beats/min), and fourteen dogs in the SAVP group (2 wk at 220 beats/min). SAVP induced less left ventricular dysfunction but more left atrial dysfunction than RVP. SAVP dogs had similar atrial effective refractory periods as RVP dogs but more heterogeneity in conduction and more AF inducibility (83% vs. 40%, P < 0.05) and maintenance (median 1,660 vs. 710 s, P < 0.05) than RVP dogs. SAVP induced more collagen turnover and was associated with a significantly greater increase in type III collagen in the atria compared with RVP dogs (6.9 +/- 1.5 vs. 4.8 +/- 1.6, respectively, P < 0.05 vs. 1.1 +/- 0.7 in unpaced control dogs). In conclusion, the SAVP model induced profound mechanical and substrate atrial remodeling and reproducible sustained AF. This new model is clinically relevant and may be useful for testing AF interventions.
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Affiliation(s)
- Gabriel Laurent
- Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
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